Background The consistency of codes governing disclosure of terminal illness to patients and families in Islamic countries has not been studied until now. Objectives To review available codes on disclosure of terminal illness in Islamic countries. Data source and extraction Data were extracted through searches on Google and PubMed. Codes related to disclosure of terminal illness to patients or families were abstracted, and then classified independently by the three authors. Data synthesis Codes for 14 Islamic countries were located. Five codes (...) were silent regarding informing the patient, seven allowed concealment, one mandated disclosure and one prohibited disclosure. Five codes were silent regarding informing the family, four allowed disclosure and five mandated/recommended disclosure. The Islamic Organization for Medical Sciences code was silent on both issues. Conclusion Codes regarding disclosure of terminal illness to patients and families differed markedly among Islamic countries. They were silent in one-third of the codes, and tended to favour a paternalistic/utilitarian, family-centred approach over an autonomous, patient-centred approach. (shrink)

Estimates of child mortality are mainly based on reports by mothers on the survival status of their children. Infant mortality estimates from such data do not seem to have declined in recent years. The Bangladesh Bureau of Statistics sample registration infant mortality estimates appear to be suspiciously low.

This article will explore different images of nature and their implications for the meaning of life in the face of death. First we will elaborate on life as creation, as expressed by Francis of Assisi in his Canticle of the Sun, and see how the imaginative power of this story gives meaning to life and death. Then we will go into the evolutionary approach of life by Richard Dawkins. In his work a totally different significance of finitude becomes visible: death (...) as a necessary segment in the development of life. The philosopher Leo Apostel states that an intellectual/scientific understanding of death is not enough; we need to explore our emotional response to the universe in order to be able to create meaning and value. The work of the biologist Ursula Goodenough and the philosopher Ton Lemaire are discussed as examples of such an affective admiration of life and death based on scientific knowledge. In the end I will conclude that scientific insights give us a lot of information about human beings as concerns their nature and the inevitability of death. But how we can affectively value and give meaning to life in the face of death is still an open question which cannot be answered by science alone. (shrink)

In some medical cases there is a moral distinction between killing and letting die, but in others there is not. In this paper I present an original and principled account of the moral distinction between killing and letting die. The account provides both an explanation of the moral distinction and an explanation for why the distinction does not always hold. If these explanations are correct, the moral distinction between killing and letting die must be taken seriously in medical contexts. Defeasibly, (...) when an agent kills she takes responsibility, but when an agent lets die she does not take responsibility. Therein lies the moral distinction between killing and letting die. The distinction, however, is defeated when an agent is already responsible for the surrounding situation. In such cases, killing does not involve taking any further responsibility and letting die does not avoid taking any responsibility. Medical examples are frequently complicated because patients' autonomous choices impact upon medical practitioners' surrounding responsibility. (shrink)

While all psychologically competent persons know that they will one day die, this knowledge is typically held at a distance, not fully assimilated. That is, while we do not doubt that we will die, there is another sense in which we cannot fully believe it either. However, on some rare occasions, we can grasp the reality of our mortal nature in a way that is seemingly revelatory, as if the fact is appreciated in a new way. Thomas Nagel calls this (...) experience ‘the expectation of nothingness’. But how can I be shocked by what I already know? After illustrating this phenomenon via examples including Tolstoy’s The Death of Ivan Ilyich, I draw on the work of Thomas Nagel, Tamar Szabo Gendler, Mark Johnston and others to articulate and explain our typical state of believing-yet-not-believing in our inevitable death, and offer a hypothesis as to how this condition is occasionally overcome, so that we grasp our mortality in a more psychologically integrated manner. (shrink)

The problem of self-determination in the dying process confronts a dilemma regarding clients’ desire to know and not to know. Ambivalence and guilt make “free choice” problematic in choosing the way to die. Telling dying clients the “whole truth” about their condition is an art or skill. The question of a meaningful death raises questions that philosophical analysis can help clarify.